Almost half of all Americans over the age of 65 will rely on nursing home (NH) care at some point in their lives, & 2 in 3 NH residents have their care covered at least in part by Medicaid. Under Medicaid, states set NH payment rates & the Fed. Gov't. reimburses a share of state spending. In light of concerns about the adequacy of NH resources, this report examine how state Medicaid programs determine NH payment rates & whether these payment methods or rates have changed given recent state fiscal pressures. State & NH industry officials in 19 states were interviewed & documentation about nursing home payment rates & methods were reviewed, including state methods to determine nursing home per diem rates for FY1998 through 2004. Tables.Allen, Kathryn G. is the author of 'Medicaid Nursing Home Payments States' Payment Rates Largely Unaffected By Recent Fiscal Pressures', published 2004 under ISBN 9780756739669 and ISBN 0756739667.